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Helping Young Surgery Patients Ease Fears Easing The Fears Of Young Surgery Patients

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By YEATIE MORGAN

Special to the Tribune

Published: June 14, 2008

Isabella Ecker-Amaral puts a surgical cap and mask on Molly the puppet, takes her pulse and listens to her heartbeat with a stethoscope. But the 6-year-old is doing more than playing doctor - she's getting comfortable with hospital procedures in advance of her surgery to alleviate any fears she may have.

Molly is the star of the Child Life program at All Children's Hospital in St. Petersburg. And she is fast becoming Isabella's best friend as she helps the little girl understand why she has to have surgery.

The Child Life program, featured at several Bay Area hospitals with pediatric wards, is used to help lessen children's anxiety and fear of upcoming surgery or treatment.
Child Life specialists use a variety of tools to engage and educate their young patients. Along with puppets, books, magazines, toys and art, specialists use all the typical instruments - like stethoscopes or IVs - that the child will be exposed to before, during and after the surgery, treatment or procedure.

"We let them manipulate the medical equipment so they can smell it or feel it," says Renee Savic, a Child Life therapist at Shriners Hospital in Tampa. "We try to involve all the senses that we can in our education. So really, our main goal is to normalize the environment while they're in the hospital."
Program specialists also try to help children understand why they need certain treatments, says Heather Bailey, a Child Life specialist at All Children's. "It's one thing to know that a nurse or a doctor may come in and say what the treatment is, but we can help them to identify why they need to do that."

Isabella's mother, Lia Ecker, is glad her daughter has someone to whom she can express her concerns, even if it is a puppet.

"Some of the procedures, like a catheter, she's had before," Ecker says. "But she doesn't know anything about an IV. It's a good way to prepare her for what's going to come so that she doesn't wake up from her surgery and want to pull it out. And she got to do to Molly what will be done to her."

The Child Life program started in the 1920s; there are now about 500 documented programs worldwide, says Susan Krug, executive director at the Child Life Council.

Child Life therapists must complete at least a bachelor's degree that emphasizes human growth and development, education, psychology or related field of study.

"We sit for a certified national exam after we've completed our degree and an internship in a clinical setting," Savage says. "Then, once we pass that exam, we're considered national Child Life specialists, and we are primarily found in hospitals."

To make the program as effective as possible, specialists work hand in hand with physicians and nursing staff. It's important to have that multidisciplinary team to make the process work, says Michelle Suarez, a Child Life therapist at All Children's.

Although the focus is the patient's peace of mind, Child Life also helps to support the family.

"If they have a sibling, we will work with the sibling and help them understand why their brother may be crying," Savage says. "It's not that we're trying to hurt them, it's that we're helping them fix their bone or whatever the case may be. And then, as far as the parent, we will help them as far as teaching them ways to support their child. So we would encourage their participation in assisting with whatever treatment or procedure is going on."

According to an American Academy of Pediatrics policy statement, most hospitals that have a pediatric care unit have a Child Life program. With so many in existence across the country and in Canada, it looks like the program is working.

"Parents tell us that their child reacts different when there is a Child Life specialist with them," Bailey says. "A lot of times, parents calm down once their children calm down. Then when they have those questions answered, their anxiety goes down, and they're better able to cope about being in the hospital and having their child in the hospital."

The program continues to expand.

"Most programs really only started out as one person covering the entire hospital," Bailey says. "Now we're getting to the point where we need more than one person in each unit."

At the end of the session, Molly says goodbye to her new friend and moves on to help another child. Ecker looks down at her daughter as she plays with a bag of goodies she received, and her eyes begin to well up with tears.

"It's hard for your baby to go to the hospital, but it's going to make everything better for her," Ecker says.

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